Provider Demographics
NPI:1417155714
Name:CLAY, CHRISTINE INEZ (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:INEZ
Last Name:CLAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17455 SAGECREEK RD
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-7915
Mailing Address - Country:US
Mailing Address - Phone:719-683-8337
Mailing Address - Fax:719-444-0656
Practice Address - Street 1:315 N WEBER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1230
Practice Address - Country:US
Practice Address - Phone:719-661-8109
Practice Address - Fax:719-444-0656
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO695106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist